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So You've Been Told You Have a Blighted Ovum

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My name is Kay. I've been managing The Misdiagnosed Miscarriage for more than a decade and have learned quite a bit about progesterone.

A blighted ovum can be difficult to diagnose, so don't hesitate to seek a second opinion before terminating your pregnancy after being diagnosed.

A blighted ovum can be difficult to diagnose, so don't hesitate to seek a second opinion before terminating your pregnancy after being diagnosed.

I am often asked questions about the diagnosis of a blighted ovum because of my own misdiagnosed blighted ovum story.

Six years ago, when facing my own diagnosis, there was virtually no information on misdiagnosed miscarriages online. In fact, women on miscarriage sites told me, kindly, to just have the D&C and move on.

Thankfully, I did not listen, and my daughter is here today.

You may or may not have that happy ending. Unfortunately, time is the only true test of a blighted ovum. I'd like to share some of what I've learned so far, so that you can make an informed decision on how and when to end your pregnancy, or whether it needs to be ended at all.

I believe every woman deserves to not have any doubts before ending her pregnancy.

What Is a Blighted Ovum?

Let's start with the basics. A blighted ovum is an egg that is fertilized but does not develop after implantation. Your doctor may also refer to this as an anembryonic or empty sac pregnancy.

Let's move on to how a blighted ovum is diagnosed.

If you are able to see a yolk sac during the ultrasound, you do not have a blighted ovum. A baby is needed for the yolk sac to appear. That does not mean the pregnancy will not end in miscarriage, it just means you do not have a blighted ovum.

How a Blighted Ovum Is Diagnosed

Note: Please read through this entire section because the criteria given to doctors for diagnosing a blighted ovum is not always correct, and mistakes are frequently made.

Unfortunately, many doctors make the diagnosis too early. In a nutshell, a physician will often diagnose a blighted ovum when the gestational sac is empty. Some women have said they were diagnosed as early as five weeks.

According to the Encyclopedia of Medical Imaging, the criteria for a diagnosis of a blighted ovum are:

  1. Failure to identify an embryo in a gestational sac measuring at least 20 mm via transabdominal ultrasound.
  2. Failure to identify an embryo in a gestational sac measuring approximately 18 mm or more via transvaginal ultrasound.
  3. Failure to identify a yolk sac in a gestational sac measuring 13 mm or more.

This is the criteria many doctors use when making the diagnosis of a blighted ovum. Fortunately, there is still hope even when these "benchmarks" are not met.

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How Do You Know If This Is Truly a Blighted Ovum?

Unfortunately, the only true way to test for a blighted ovum is time. If you've been told a baby is always seen by seven or eight weeks, you've been misinformed. Many women with gestational sacs measuring bigger than the 20 mm find their babies after eight weeks.

The UK is the first to acknowledge that misdiagnosed miscarriages are indeed a problem. The Royal College of Obstetricians and Gynecologists have revised their guidelines. If your gestational sac is more than 25 mm and/or the CRL is 7 mm or more, you should wait a week to verify, if there are no complications. If the measurements are less, you are too early to diagnose.

The vast majority of women who find their babies after eight weeks have a tilted uterus. Although some women who have an anteverted uterus (normal position) have found their babies later as well.

Does a Tilted Uterus Matter?

First things first, if you are being diagnosed with a blighted ovum before nine weeks, it is too early to know with certainty that it is indeed a blighted ovum. If you do not know if you have a tilted uterus, you need to ask your doctor because that should be verified before making a diagnosis.

After nine weeks, some women have reported finding their babies. Although most women see their babies by nine weeks, some women have been further along. We don't know the explanation as to why it takes so long to view some babies, but it does happen.

Also, do not be worried if you are told you look one to two weeks behind. Many women with a tilted uterus look one to two weeks behind even if they are certain of their conception date. In fact, many women are misdiagnosed after IVF for this very reason. Once these women hit the second trimester, and their uterus is no longer retroverted, their dates line up.

How Do You Know When to End the Pregnancy?

If you would rather have a medical miscarriage, called a dilation and curettage (D&C), than a natural miscarriage, that is your right. Many doctors still encourage a natural miscarriage up to ten weeks. After ten weeks, even if you decide to have a natural miscarriage, you are more likely to need a D&C due to complications.

Low hCG Levels

Keep in mind that hCG levels start to slow down and plateau or even decline after seven or eight weeks of pregnancy. So hCG monitoring is not an accurate way to determine if this is a blighted ovum. However, if you are monitoring your hCG levels and they are significantly dropping, then you know your body is probably preparing for m